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低剂量CT扫描诊断肺孤立性磨玻璃结节良恶性的价值

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目的 探讨低剂量CT扫描在肺孤立性磨玻璃结节良恶性鉴别诊断中的应用价值。方法 选取2021年8月—2023年10月于永州市第三人民医院就诊的62例肺孤立性磨玻璃结节患者为研究对象,均接受低剂量电子计算机断层摄影CT扫描,以病理诊断结果为"金标准",比较低剂量及常规CT扫描的辐射剂量,并探究低剂量CT扫描的敏感度、特异度及准确率,比较良恶性病变的影像学特征、不同时间段的动态增强CT值。结果 低剂量CT扫描的CT剂量指数(computed tomography dose index,CTDI)为(2。46±0。42)mGy,剂量长度乘积(dose length product,DLP)为(139。56±43。74)mGy·cm及有效剂量(effective dose,ED)为(1。98±0。66)mGy,均低于常规CT扫描的(9。06±0。55)mGy、(256。55±43。25)mGy·cm及(3。62±0。62)mGy,差异有统计学意义(P<0。05)。以"金标准"为依据,低剂量CT扫描的敏感度为95。24%、特异度为80。00%、准确率为90。32%;良性病变边缘清晰,其内部结构以钙化为主,而恶性病变边缘呈现毛刺或不规则形态,内部结构均匀,组间比较差异有统计学意义(P<0。05)。恶性病变30、90、180、300、480 s动态增强CT值分别为(64。85±8。44)Hu、(71。65±10。33)Hu、(68。45±9。45)Hu、(64。58±8。46)Hu、(62。42±8。52)Hu,均高于良性病变的(35。52±5。64)Hu、(24。65±3。26)Hu、(39。58±6。77)Hu、(35。46±5。66)Hu、(34。65±5。44)Hu,差异有统计学意义(P<0。05)。结论 经低剂量CT扫描鉴定诊断肺孤立性磨玻璃结节良恶性病变的效果确切,具有较高的敏感度及特异度,有助于医师尽早发现恶性病变,为患者疾病治疗方案拟定提供可靠参考,促进其预后改善。
Value of Low-Dose CT Scanning in Differential Diagnosis of Benign and Malignant Solitary Pulmonary Ground-Glass Nodules
Objective To explore the value of low-dose CT scan in the differential diagnosis of benign and malignant isolated lung ground glass nodules.Methods A total of 62 patients with isolated ground glass nodule of lung who visited the Third People's Hospital of Yongzhou from August 2021 to October 2023 were selected as the study objects.All of them received low-dose CT scanning.The pathological diagnosis results were used as the "gold standard" to compare the radiation doses of low-dose and conventional CT scanning.The sensitivity,specificity and accuracy of low-dose CT scan were investigated,and imaging features of benign and malignant lesions and dynamic enhanced CT values in different time periods were compared.Results The computed tomography dose index (CTDI) of low-dose CT scan was (2.46±0.42) mGy,the dose length product (DLP) was (139.56±43.74) mGy·cm,and the effective dose (ED) was (1.98±0.66) mGy,all lower than those of conventional CT scan (9.06±0.55) mGy,(256.55±43.25) mGy·cm and (3.62±0.62) mGy,with statistically significant differences (P<0.05).Based on the "gold standard",the sensitivity of low-dose CT scan was 95.24%,specificity was 80.00% and accuracy was 90.32%;benign lesions had clear margin,its internal structure was mainly calcification,while malignant lesions showed burr or irregular state,uniform internal structure,obvious difference between groups (P<0.05).The dynamic contrast-enhanced CT values of malignant lesions at 30,90,180,300,and 480 seconds were (64.85±8.44) Hu,(71.65±10.33) Hu,(68.45±9.45) Hu,(64.58±8.46) Hu,and (62.42±8.52) Hu,respectively,which were higher than those of benign lesions of (35.52±5.64) Hu,(24.65±3.26) Hu,(39.58±6.77) Hu,(35.46±5.66) Hu,and (34.65±5.44) Hu,and the differences were statistically significant (P<0.05).Conclusion The diagnosis of benign and malignant lesions of isolated lung ground glass nodules by low-dose CT scan is effective,with high sensitivity and specificity,which can help doctors to detect malignant lesions as soon as possible,provide reliable reference for the treatment plan of patients,and improve their prognosis,which is worth popularizing.

low doseCT scanisolated pulmonary ground glass nodulesbenign and malignant lesionsidentification and diagnosisvalue

蒋利军、唐静

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永州市第三人民医院放射科,湖南永州 425000

低剂量 CT扫描 肺孤立性磨玻璃结节 良恶性病变 鉴定诊断 价值

2024

中国卫生标准管理
《中国卫生标准管理》杂志社

中国卫生标准管理

影响因子:1.374
ISSN:1674-9316
年,卷(期):2024.15(21)